Constipation is a common problem in children. It accounts for 20–30% of pediatric outdoor office. It is common in both rich and poor countries despite the belief that developing countries consume food rich in fiber. Normal bowel movement in breastfed babies may range from several times a day to once in every 10 days. Constipation can be both functional and pathological. Functional constipation has no underlying cause and is the most common type of constipation found in children. My main focus will be on this common type of constipation. In functional constipation routine, digital rectal examination is not recommended unless impaction is suspected. Abdominal radiography is recommended only in equivocal clinical examination or if impaction is suspected and examination not conclusive. Dietary and behavior modifications, toilet training, and parent education are important in the management of functional constipation. Initial management of functional constipation includes disimpaction of stools. Lactulose is safe in all age groups. Polyethylene glycol is more effective than lactulose but is costly. Maintenance therapy may take some time till constipation improves. Some rare situations such as refractory and slow transient constipation are also discussed in this chapter.
Part of the book: Constipation